1. Field of the Invention
This invention relates to an information recording system and method of proofing the information.
2. Description of the Prior Art
Traditionally, people record information by means of hand written notes or by entering the information into a computer using standard word processing software. In the medical environment, healthcare professionals such as physicians and nurses record medical information about patients. This will include background about the patient, such as the patient""s age and sex, patient history, physical examination, and subsequent information that is developed during discussions with the patient.
The physician typically requires the patient to fill out a questionnaire disclosing the personal information about the patient, the patient""s background, medical information and pre-existing medical conditions. During the patient visit and thereafter the physician usually makes notes. As part of the process, the physician makes a determination regarding the patient""s medical condition and defines a treatment plan.
Physicians often use a dictation and transcribing approach to record this information. However, the requirements upon physicians are becoming increasingly burdensome requiring not only a recording of information about each patient""s office visits, a diagnosis and suggested treatment plan, but recently has also required the physician to allocate points based on the extensiveness of his examination and the expertise required of him, to facilitate appropriate compensation by government, and perhaps, in the future, other insurance plans.
One data entry proposal is disclosed in U.S. Pat. No. 5,704,371 which discloses a medical history documentation system and method for recording information. The system disclosed in the ""371 Patent involves the communication of encoded indicia by a first person to a second person during a patient examination by the first person. The second person records this information on a recording device, entering coded indicia, leaving the first person free to do the examination without the first person having to make personal notes, or fill out forms or otherwise take time to write down information. The system suffers from the disadvantage of requiring a second person. It also does not provide for the allocation of points to the input information.
Speech recognition software has recently become available for desk top computers, such as Dragon Dictate, and IBM Voice Type. Dragon Dictate can interface with different applications, including word processors. However, it suffers from the disadvantage that there is no audio recording of the dictation stored for replaying during editing. While the IBM VoiceType version retains both a sound and a text file, the text from the speech recognition engine is input directly into a propriety text processor. The system decides when the speech recognizer models are updated, and does not allow direct updating of the sound files. U.S. Pat. No. 5,799,273 addresses the issue of allowing audio data to be stored corresponding to the edited text by updating the audio file when the text file is edited. It does not, however, provide a facility for highlighting suspicious text portions for the benefit of a proofreader and no facility exists to associate positional information with the text to ensure that data input into a document having a predefined format and layout does not get corrupted during editing by inadvertently ending up in a different section of the document.
The present invention seeks to provide an efficient means of gathering data in a structured document and subsequently verifying the accuracy of the data while also associating other information with the data such as points allocated to certain portions of the data.
According to the invention there is provided a system and method for data entry and decision making which includes a prompting stage, which prompts the user to enter data. One embodiment disclosed is a medical application. However, the invention is not so limited.
The input of the information involves the use of a computer. The user of the system inputs the information using any suitable input device, including a keyboard, oral input in conjunction with speech-recognition software, touch screen or mental manipulation of a cursor, etc., or any combination thereof.
The system and method of the invention further includes backtracking functionality for entry of subsequent further necessary data, and additional backtracking functionality where the necessary minimum data has been entered but a decision making process determines that the user may desire to add further data.
The method may include an accuracy monitoring capability to monitor, and possibly, make perceived corrective changes to the entered data. The method may, for instance, include a dictionary of undesired terms and/or a dictionary of desired terms which compares the entered data to the dictionary of words or phrases, and highlights and/or offers alternative terms or phrases from which to choose, or corrects perceived incorrect data. Separate dictionaries dealing with different categories, e.g., symptoms, anatomical regions, etc., may be included for use by one or more different data entry locations. Alternatives may be displayed based on the category or categories associated with that part of the document.
The method may be implemented in. a client-server system wherein all or some of the data and quantitative measure assigned to the data is sent from the client to the server for evaluation. The data may, for example, include text that is proofread by a person on the server side or is transferred to a third party proofreader via a server or directly from the user who enters the data.
Typically the information is put into a document having a predefined structure, with one or more sections, each section having one or more data entry locations, and the user is provided with the ability to jump forward and backward in the document. Thus, data entry may take the form of input into a predefined table or form having a certain layout. Different forms may be provided depending on the complexity of the case and the nature of the user. Structural information associated with the data may be retained through the use of a database or, if the data is serialized, by associating tags with the data, thereby retaining the structural information. Thus the complexity of the document chosen by the user will determine the number of rows pulled up from the database table for data entry.
In addition to merely highlighting the next data entry location, a visual or oral prompt may offer one or more choices from which the user may select.
Further, according to the invention there is provided a calibrated document having a predefined structure having one or more sections to which points or another quantitative measure can be assigned. The points can be manipulated such as by adding some or all of the points.
The method and system can include a scoring stage in which points or another quantitative measuring feature is ascribed to the data. The resultant score is manipulated, such as by adding the points for a section of the document or for the document as a whole, to provide a quantitative measure, facilitating further action or a decision making process, such as supporting a given level of billing.
The points or other quantitative measure of the data input may serve to measure the qualitative and quantitative value of tasks performed by a user. For instance, a physician examining a patient, may be given points based on the extensiveness of the patient evaluation and the complexity of the diagnosis. He may also be given points based on the severity of the patient""s illness or the amount of expertise required of the physician.
The method is implemented on a computer system and the system may include functionality for prompting the user in order to maximize the points. Thus, the system may determine that the number of points for a particular section can be increased by entering merely one or two additional categories. By monitoring the accumulated points for a particular section or for the document as a whole, and by determining a distance to the next predetermined threshold level, the system may prompt the user for additional input. This may be achieved by providing a visual representation of the data collected, e.g., using a tree structure.
In order to assign points or other quantitative measures to the entered data, each piece of information is predefined as being associated with one or more points or other quantitative measure. Thus, a single response may include more than one element and have more than one point attributed to it.
The system may also adjust the prompting of the user for data input by monitoring a user rhythm or speed of data entry, and may proceed to the next determined data entry location after a system-determined period of time. Alternatively, speed of data entry may be user determined, wherein the cursor or other prompt on a computer monitor (e.g., a highlighted data entry location indicating the area of data input) moves to the next determined data entry location once data has been entered by the user into the previous data entry location or after a period of time set by the user. Where the system establishes a user rhythm in moving from one data entry location to the next, the speed may be manually adjusted by the user, or interrupted by means of a pause feature.
Data entry may also be facilitated by making use of predefined portions of data such as text which are insertable by using a keystroke or keyword, for example, and can, for simplicity, be referred to as macros. Such macros may cover more than one data entry location and can result in the assignment of points or filling in of scores for the associated multiple locations. These scores may be predefined or calculated by the system.
Further, according to the invention there is provided a proofreading process, wherein data is entered orally using speech-recognition software. The process may be implemented on a system that includes a spell checker (for data that was entered using a keyboard or was entered by specifying the individual letters constituting a word) and/or a grammar checker. It also includes a mechanism, in the form of Soundex codes, for performing an acoustic analysis. The various data accuracy mechanisms may include means for prompting a user with alternatives to choose from. The system may also include a list of unexpected terms. This allows data corresponding to an unexpected term to be highlighted, alternatives presented, and/or replaced with an alternative. Where the term or terms are highlighted a person acting as proofreader will be prompted to verify and, if necessary, correct the data entry.
The system may also store the data both as a sound file and as a text file that is created pursuant to conversion by speech-recognition software. In this situation, a proofreader may receive both an audio version of the data and a text version that is synchronized with the audio version. As such, the method envisages the proofreader reviewing the text visually while simultaneously listening to the audio version. Words or phrases of concern may be visually highlighted by the system in the text version. The audio version may also include a sound marker to identify a word or phrase of concern. Thus, the system includes transmitting both a sound file and a text file to the proofreader, synchronizing the two files and including means for highlighting or otherwise emphasizing words or phrases requiring specific attention of the proofreader. The text file also includes positional information associated with the data to define the location of the text in the document, as well as points information about the data.
Changes made to the data by the proofreader are typically sent back to the user together with positional or structural information, and any points changes, to allow the data on the user side to be corrected, and also to teach the speech-recognition software.
As mentioned above, to facilitate the data input, predefined portions of data, referred to here as macros, may be provided allowing the input of predefined portions of data, such as text. These macros may immediately be inserted into the table, form, or other document and may be demarcated visually in the text version when displayed on a visual output device such as a computer monitor. The macro may also be audibly demarcated in the sound file to indicate to a listener, the beginning and the end of the macro. Alternatively, the insertion point of a macro may merely be indicated in the text file without actually inserting the data. It may, thus, be defined by a suitable visual indicator when viewed on a monitor, for example, by means of a keyword. Similarly the insertion point of the macro in the sound file may be indicated by an audible tag such as a keyword which is audible to the listener. Thus the proofreader need not get involved with the macro data, e.g., the wording, in the case of text data, and is merely provided with an indication as to the point of insertion of the macro in the rest of the document, or the macro text may be displayed but automatically skipped over by the system during proofreading. In one implementation, data inserted into the document may be associated with tags to ensure that the data may be stored in a database while retaining structural and other information about the data. The proofreader may be presented with some or all of the data, while some or all of the structural or other information (e.g., points allocated to the data) may be withheld from the proofreader. Sensitive data may also be withheld from the proofreader or require a password to restrict access.
Preferably the playback speed is adjustable by the proofreader, both the audio and text versions working in synchrony with each other to ensure that the text follows the playback of the sound file and vice versa. This is achieved, for example, by placing tags or synchronization markers in the text and sound file, or by including speech-recognition software and a search engine to locate a portion of the text file corresponding to a portion of the sound file, or by saving the text and corresponding sound file portions in one table or linked tables of a database. Thus, the user can fast forward or rewind through either file or jump around in a file without losing synchronization.
In the above physician/patient context as well as in any other applications, the service provided by the service provider of providing a physician with means for collecting data about his patients can be used by the service provider as a revenue stream from the users (e.g., physicians). The physician or other user may be required to pay a fee for the use of the patient or other data acquisition software.
Revenue streams may also be obtained from users of the data entry software by providing the optional proof-reading service that can, conceivably, be performed at a remote low labor cost location.